Melinda Santiago of Allentown said, "[My] personal opinion? It's up to somebody else if they want to maintain health, it's up to them."

But Tom Croyle with the Lehigh Valley Business Coalition on Health Care says efforts to reward employees for healthy choices aren't bringing costs down enough. So more companies are now opting for penalties.

"There's a real concern about what we would call 'ticking time bombs,'" he said. "You have to strike a balance. You have to focus on things that are within the employee's ability to control."

And according to Croyle, the cost goes beyond insurance premiums.

"What it does for the productivity of the employee," he said.

But DiFranco thinks penalties go too far.

"Maybe look at how you're incentivizing them," he said. "If it's not motivating them enough, I don't think it should be ... changed to be a penalty."

Businesses are doing their part too. They now rate insurance plans... which gives them a lot more leverage when it comes to the prices they charge.

As for whether penalties work, Croyle said there aren't good ways of measuring that yet.

"I think the effectiveness is still out there -- yet to be determined," he said. "But what I would say is that those people who have implemented wellness programs-- prevention programs-- are seeing lower health care cost trends."

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